Postoperative pain surveys in Italy from 2006 and 2012. (POPSI and POPSI-2)

OBJECTIVE: Despite established standards, effective treatments, and evidence-based guidelines, postoperative pain control in Italy and other parts of the world remains suboptimal. Pain control has been recognized as a fundamental human right. Effective treatments exist to control postsurgical pain. Inadequate postoperative analgesia may prolong the length of hospital stays and may adversely impact outcomes. MATERIALS AND METHODS: The same multiple-choice survey administered at the SIAARTI National Congress in Perugia in 2006 (n=588) was given at the SIAARTI National Congress in Naples, Italy in 2012 (n=635). The 2012 survey was analysed and compared to the 2006 results. RESULTS: Postoperative pain control in Italy was less than optimal in 2006 and showed no substantial improvements in 2012. Geographical distinctions were evident with certain parts of Italy offering better postoperative pain control than other. Fewer than half of hospitals represented had an active Acute Pain Service (APS) and only about 10% of postsurgical patients were managed according to evidence-based guidelines. For example, elastomeric pumps for continuous IV infusion are commonly used in Italy, although patient-controlled analgesia systems are recommended in the guidelines. The biggest obstacles to optimal postoperative pain control reported by respondents could be categorized as organizational, cultural, and economic. CONCLUSIONS: There is considerable room for improvement in postoperative pain control in Italy, specifically in the areas of clinical education, evidence-based treatments, better equipment, and implementation of active APS departments in more hospitals. Two surveys taken six years apart in Italy reveal, with striking similarity, that there are many unmet needs in postoperative pain control and that Italy still falls below European standards for postoperative pain control

Liquid Limits: The Glass Transition and Liquid-Gas Spinodal Boundaries of Metastable Liquids

The liquid-gas spinodal and the glass transition define ultimate boundaries beyond which substances cannot exist as (stable or metastable) liquids. The relation between these limits is analyzed {\it via} computer simulations of a model liquid. The results obtained indicate that the liquid - gas spinodal and the glass transition lines intersect at a finite temperature, implying a glass - gas mechanical instability locus at low temperatures. The glass transition lines obtained by thermodynamic and dynamic criteria agree very well with each other.Comment: 5 pages, 4 figures, to appear in Phys. Rev. Let

Numerical study of a short-range p-spin glass model in three dimensions

In this work we study numerically a short range p-spin glass model in three dimensions. The behaviour of the model appears to be remarkably different from mean field predictions. In fact it shares some features typical of models with full replica-symmetry breaking (FRSB). Nevertheless, we believe that the transition that we study is intrinsically different from the FRSB and basically due to non-perturbative contributions. We study both the statics and the dynamics of the system which seem to confirm our conjectures.Comment: 20 pages, 15 figure

Statistical Physics of Structural Glasses

This paper gives an introduction and brief overview of some of our recent work on the equilibrium thermodynamics of glasses. We have focused onto first principle computations in simple fragile glasses, starting from the two body interatomic potential. A replica formulation translates this problem into that of a gas of interacting molecules, each molecule being built of $m$ atoms, and having a gyration radius (related to the cage size) which vanishes at zero temperature. We use a small cage expansion, valid at low temperatures, which allows to compute the cage size, the specific heat (which follows the Dulong and Petit law), and the configurational entropy. The no-replica interpretation of the computations is also briefly described. The results, particularly those concerning the Kauzmann tempaerature and the configurational entropy, are compared to recent numerical simulations.Comment: 21 pages, 6 figures, to appear in the proceedings of the Trieste workshop on "Unifying Concepts in Glass Physics

Microscopic theory of network glasses

A molecular theory of the glass transition of network forming liquids is developed using a combination of self-consistent phonon and liquid state approaches. Both the dynamical transition and the entropy crisis characteristic of random first order transitions are mapped out as a function of the degree of bonding and the density. Using a scaling relation for a soft-core model to crudely translate the densities into temperatures, the theory predicts that the ratio of the dynamical transition temperature to the laboratory transition temperature rises as the degree of bonding increases, while the Kauzmann temperature falls relative to the laboratory transition. These results indicate why highly coordinated liquids should be "strong" while van der Waals liquids without coordination are "fragile".Comment: slightly revised version that has been accepted for publication in Phys. Rev. Let

The Glass Transition and Liquid-Gas Spinodal Boundaries of Metastable Liquids

A liquid can exist under conditions of thermodynamic stability or metastability within boundaries defined by the liquid-gas spinodal and the glass transition line. The relationship between these boundaries has been investigated previously using computer simulations, the energy landscape formalism, and simplified model calculations. We calculate these stability boundaries semi-analytically for a model glass forming liquid, employing accurate liquid state theory and a first-principles approach to the glass transition. These boundaries intersect at a finite temperature, consistent with previous simulation-based studies.Comment: Minor text revisions. Fig.s 4, 5 update

Clinical relevance of silent red blood cell autoantibodies.

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Exchange Monte Carlo Method and Application to Spin Glass Simulations

We propose an efficient Monte Carlo algorithm for simulating a ``hardly-relaxing" system, in which many replicas with different temperatures are simultaneously simulated and a virtual process exchanging configurations of these replica is introduced. This exchange process is expected to let the system at low temperatures escape from a local minimum. By using this algorithm the three-dimensional $\pm J$ Ising spin glass model is studied. The ergodicity time in this method is found much smaller than that of the multi-canonical method. In particular the time correlation function almost follows an exponential decay whose relaxation time is comparable to the ergodicity time at low temperatures. It suggests that the system relaxes very rapidly through the exchange process even in the low temperature phase.Comment: 10 pages + uuencoded 5 Postscript figures, REVTe

Fluctuation dissipation ratio in an aging Lennard-Jones glass

By using extensive Molecular Dynamics simulations, we have determined the violation of the fluctuation-dissipation theorem in a Lennard-Jones liquid quenched to low temperatures. For this we have calculated $X(C)$, the ratio between a one particle time-correlation function $C$ and the associated response function. Our results are best fitted by assuming that $X(C)$ is a discontinuous, piecewise constant function. This is similar to what is found in spin systems with one step replica symmetry breaking. This strengthen the conjecture of a similarity between the phase space structure of structural glasses and such spin systems.Comment: improved data and metho

Spin-Glass Model for Inverse Freezing

We analyze the Blume-Emery-Griffiths model with disordered magnetic interaction displaying the inverse freezing phenomenon. The behaviour of this spin-1 model in crystal field is studied throughout the phase diagram and the transition and spinodal lines for the model are computed using the Full Replica Symmetry Breaking Ansatz that always yelds a thermodynamically stable phase. We compare the results both with the quenched disordered model with Ising spins on lattice gas - where no reentrance takes place - and with the model with generalized spin variables recently introduced by Schupper and Shnerb [Phys. Rev. Lett. 93, 037202 (2004)]. The simplest version of all these models, known as Ghatak-Sherrington model, turns out to hold all the general features characterizing an inverse transition to an amorphous phase, including the right thermodynamic behavior.Comment: 6 pages, 4 figures, to appear in the Proceeding for the X International Workshop on Disordered Systems (2006), Molveno, Ital